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Bad breath

Bad breath happens to everyone at some point, and research suggests that between 25% and 50% of people are regularly affected. Known medically as halitosis, bad breath is best tackled by addressing the cause rather than simply disguising the problem with breath fresheners.

Causes of bad breath

Most bad breath is due to poor oral hygiene, food or drink, or dehydration, but sometimes it can be a sign of an underlying health problem. The possible causes are wide-ranging and include:

Poor oral hygiene – food remaining on or between your teeth is broken down by bacteria, which release unpleasant smells; this can lead to tooth decay and gum disease, worsening the problem

Diet – some foods such as raw onions, garlic and spices can produce odours after digestion, when they enter your bloodstream and reach your lungs

Dry mouth – saliva helps keep bacteria under control, so if you don’t produce enough, bacteria will build up

Smoking – the chemicals in cigarettes directly cause bad breath as well as damaging gums, increasing the risk of gum disease

Alcohol – it’s dehydrating, increases the bacteria linked to gum disease and raises the risk of acid reflux, another cause of bad breath

Talk to your doctor if you’re concerned about symptoms

Conditions related to bad breath

This includes infections of the mouth, nose, throat and lungs, such as dental abscesses, sinusitis, tonsillitis and bronchitis.

Gastrointestinal conditions

Acid reflux, when stomach acid leaks back up into your oesophagus (gullet), causing a burning sensation

Infection with the bacterium Helicobacter pylori, which increases risk of stomach ulcers

Diabetes

If diabetes is undiagnosed or poorly controlled, your body isn’t able to break down glucose for energy, so it breaks down fat instead. It’s this that causes the production of chemicals called ketones, which have a sweet, fruity odour.

Other causes are:

Sjögren’s syndrome

Liver or kidney problems

Some cancers

Getting a diagnosis for bad breath

If you think you have bad breath, see your dentist. They can check for signs of tooth decay, gum disease and infections and can spot signs of some serious conditions such as mouth cancer. They may recommend:

A visit to the hygienist who can give your mouth and gums a thorough clean and advise you on dealing with gum disease

A visit to your GP who can assess any possible medical cause

Tests

To determine possible causes, your GP may:

Ask about other symptoms you may have

Get you to breathe out from your nose and your mouth separately and smell your breath to help determine the cause

Refer you for blood tests to rule out or diagnose other conditions

Treatments for bad breath

Treatments vary widely, depending on the cause. Here are some of the most common solutions for getting rid of bad breath:

Good oral hygiene routine

This will involve:

Brushing twice a day for two minutes at a time

Flossing or using an interdental brush once a day

Brushing your tongue to remove bacteria daily

Using a mouthwash that doesn’t contain alcohol – your dentist can advise

Changing your toothbrush at least every three months

Going for regular dental hygiene appointments and check-ups

Lifestyle changes may include:

Quitting smoking

Drinking plenty of water

Avoiding too much pungent food and drink such as onions, garlic, spices and coffee